The ACA is going to drive all the low-information voters nuts. It's too complex -- exchanges, policy selection, penalties -- to be understood by people with only a marginal interest/understanding of economics, civics, personal finance, and personal accountability. Heck, a large number of these people don't even realize that the ACA is law. They just want to get their free stuff delivered to them.

The high-information voters knew right from the start that this law was far too complex to be implemented well by our government. And that was before the IRS scandal. Our government fails to deliver well on less complex matters.

Obamacare attempts to fix a serious problem that the Republicans seemed content at the time to either ignore, or make worse, so just in that it is to be commended. But it is exactly the kind of legislation Democrats are known for... incredibly complex and filled with micromanagement. Plus, it did not really solve the root cause of the issue: Employers should not have anything to do with health insurance. That they do is, as a previous TE article put it, "a historical accident". Obama had a slim window to completely rewrite the Health Care system in this country, and instead he and the Dems wrote a spaghetti code law that just acts as a band-aid on an inherently flawed system. I'm not advocating Single-Payer, per se, but this can't be the best solution. The Democrats wasted an opportunity on a byzantine solution few people like, and the Republicans wasted an opportunity by not putting forward a good, effective solution or even bothering to work with the Dems at the time to fix Obamacare and pass it in a bipartisan manner. If the republicans had played ball, it would have generated some much needed good will from the center, and might have even won them the 2012 election. Instead we got childish bickering and either denial that there was even a problem or proposals that would have made things worse than they already were. And so we are left with Obamacare.

I agree with you that Republicans should have had their own plan. If they had, perhaps things would have ended differently. However, I cannot see how they could have possibly worked with democrats at the time to obtain something acceptable to both sides. The democratic party was dead-set on a massive new government entitlement, and almost anything of that sort is going to be anathema to conservatives. Not to mention that the left was still riding very high after the victory of 2008, and were very unlikely to compromise on substance.

Considering how close Obamacare is to the Republican plan from a decade ago, it seems quite likely that the originally Heritage Foundation plan (or something very like it) could have gotten passed into law. Especially if our party had been moved to do so back then, rather than just sitting back and hoping that nothing would ever change.

See, none of this would be a problem if health care were decoupled from employment.

In my view, the 50-worker provision is even too weak. Half of the working uninsured are either self-employed or in small businesses. With small businesses exempt from this provision, many states refusing to expand Medicaid, and a delay in the range of choices for small business exchanges, many people will fall through the gap, and for many the individual mandate provides the only incentive, which is not as effective and penalizes workers instead of businesses. In addition, this provision does not account for the fact that some small businesses have a broad range of financial resources (e.g. hedge funds and law firms) while others would actually struggle to expand coverage. A penalty based on a sliding pay scale would remedy this problem.

Ultimately, the U.S. will need to create a public option or switch to single payer to make meaningful decreases to the alarming growth in health care costs. Either would save the government a lot of money, finally create universal coverage, and substantially decrease premiums for many Americans. The public option has broad support: around 90 percent for both Democrats and Republicans. Heck, because a healthy workforce is also more productive, businesses should support it because it ultimately helps them!

Hear, hear. Offering insurance through employment is a product of WWII, when the government needed to attract more workers to factory jobs but had already assigned fixed wages to those jobs. The sooner we do away with relics of price controls, the better.

What does basic economics dictate when prices pushed artifically low (ie. single payer)? Demand exceeds supply. What happens when demand exceeds supply? Quality and quanity both decrease. Ya, great solution you have there with single payer...

True, lines for certain treatments are going to get longer with single payer. However, increased costs do not always correlate with better outcomes: in fact, some of the most expensive providers of health care in the U.S. actually have worse outcomes.

In addition, under the public option for instance, people still have the option to go towards a private insurer if they want increased services, speed, or quality. Even under single payer, people can travel abroad if the lines prove too long. For the vast majority of people, this system would be much better because they will not have to make outrageous payments on deductibles or out-of-pocket payments, which are a leading cause of bankruptcy in America.

-abolish all new technology & treatments and get pre-1960 medicine-palliative care- the Liverpool Pathway to your grave

-and /or eradicate 40% of our 340 million American population .

The government created MediCaid to "cut costs"
-Did it work ? Few Doctors take it because they would go broke-- re-imbursement is so low.
If the govt become the sole insurer - its Medicare fund is already overdrawn in the trillions , just where will the money come from ?

Last time I heard, medical expenses account for less than 10% of bankruptcy cases. If you agree with the economics, then you also understand that quality necessarily decreases. ‘Outcome’ discrepancies are based on biased and erred statistical analyses, the better example would be to see where people go for treatment if they have the choice, answer: the US. Also, you don’t understand that single payer destroys private practice, limiting it to only the very wealthy, such as concierge medicine. I’m not arguing that the US had a perfect system, it obviously didn’t, however single payer would be hugely detrimental to a very large majority of Americans, to say nothing of the very negative effects on an already deficit ridden budget.

"Another Harvard study released in May found that in 2007, 65% of personal bankruptcies had involved high medical bills. Most of those people had insurance. But even with insurance, their annual out-of-pocket medical bills averaged over $17,000. Yup, that'll do it."

This came right out of the economist Now I considered the economist to be pretty good about there stats.

You seem to be neglecting the fact that all the single payer systems in place provide less expensive healthcare AND better outcomes than the US private healthcare system does. The profit motive will always guarantee that US healthcare lags because there's little incentive to give *good* quality care since it doesn't generate more profit. In fact, shoddy healthcare tends to be more profitable for hospitals under the current system.

Easy way to fix a supply problem is to create more supply. Start giving out more scholarships to more people that want to go to medical school. There should be more doctors anyway the reason why there isn't is because its so expensive. Also people don't need to see a doctor for everything it doesn't require a doctorate to treat 90% of the reasons why people go see the doctor. How about using nurse practitioner then if the practitioner spots a problem they send them to the specialist.

Come on people the status quo "add your own adjective". Roughly 26,000 people die every year from lack of health care not to mention the economic cost suffered from thousands of people who can't work because they can't get proper treatment. Obamacare was not the solution america needed it has some good things in it but doesn't go nearly far enough. The only way to fix the health care problem is to come up with a system that correctly aligns the incentives of all party's. I don't buy it that it can't be done that's just a cop out. The only reason why it hasn't been done yet is because of the corporate interests in this country that won't allow it. Stop coming up with reasons why something doesn't work and start coming up with real solutions.

Nonsense. The profit motive *increases* quality in every other industry. Who wants to buy a shoddy car, for instance? Why doesn't it work in healthcare? Simple, you do not actually buy your own health insurance. For the vast majority of people, you either get it from your employer or from the government.

If you're in a hurry, or want better quality than you think you would get from the single payer system, there is nothing to prevent you from going out and buying something outside the system. Just like you can go out now and buy cosmetic surgery which is not covered by your insurance.

Medical tourism sees people going to India, Thailand and other countries where hips, bypasses and what not can be had for fraction of US costs, by US trained doctors. As more people become aware of the price differentials, travel might expand.

When you can fly to another country, get a procedure, recouperate in a private room with a private nurse, then relax at a resort for two weeks for fraction of the price here in the US, I'd do it.

Do you really think that proves your point? 'Involves' does not mean caused by, that study intentionally inflates the statistics. Also noticed how it was conducted in 2007, any recent study would show a markedly different story.

The solution to problems caused by massive economic distortions from government policy is… More massive economic distortions caused by economic policy! Look at the two most heavily regulated industries, health care and Wall St. Government does not have a good tract record when intervening in the market…

Want a solution? Repeal Obamacare, repeal state regulations, make pricing transparent, and allow the market and individuals to figure out their own needs. If people want to risk their health by not buying insurance, that is their decision.

According to Phil Klein, 41 percent of the businesses surveyed by Gallup have frozen hiring because of the health-care law known as Obamacare. And almost one-fifth (19 percent) answered “yes” when asked if they had reduced the number of employees you have in your business as a specific result of the Affordable Care Act.

We had to pass the bill to see what’s in it, and now we’ll have to implement the bill without an employer mandate to see what it looks like in practice. Presumably a bunch of businesses will simply drop coverage and leave workers to fend for themselves on the new ObamaCare exchanges. Assuming that those are ready by next year. Don't blame me; I voted for the other guy.

Obamacare was labelled a "TAX" by the Supreme Court.
TE's "expanded coverage" is their socialist euphemism for taxing healthy young people who don't need & won't use health insurance to pay for care of the indigent & the feckless.
You are right---the law of unintended consequences--- stepped in with this monstrous Pelosi-Reid bill.
It is killing jobs-particulary at the margins, for youngsters and entry level trainees , whom businesses can do without.
LBJ's Medicare law in 1964 started this mess , eventually cutting payments to hospital & Doctors--against all the govt's pledges otherwise.
Politicians lie. What else is new ?
This balloon squeezed the cost shift to the private insurers .
Then rates skyrocketed & hospitals charged $30 for an aspirin.
--Such is the effect of well meaning social welfare legislation.
Even the Democrats call Obamacare a ******* train-wreck !
REPEAL IT NOW !